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[P-41] Sleep disturbance among people in Minamisanriku town after the Great East Japan Earthquake

*Yayoi Nakamura¹, Tomomi Suda¹, Aya Murakami¹, Hiroyuki Sasaki¹, Ichiro Tsuji², Yumi Sugawara², Masafumi Nishizawa³, Kazuaki Hatsugai³, Shinichi Egawa¹ (1. Division of International Cooperation for Disaster Medicine, International Research Institute of Disaster Science (IRIDeS), Tohoku University, 2. Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, 3. Minamisanriku Hospital)

Keywords:disaster medicine, medical needs, non-communicable disease, prescription, sleep disturbance

In 2011, the Great East Japan Earthquake (GEJE), all medical facilities (one hospital and four clinics) in Minamisanriku town were lost by earthquake and tsunami. A variety of medical needs people including residents and responders arised and changed dynamically. We analyzed the risk factors for sleep disturbance using anonymized disaster medical records (DMR). Out of 10,460 valid records with 18,525 diagnoses from March 11 through May 13, we identified 1,498 patients with sleep disturbance who was diagnosed and/or who got prescription of sleeping or anxiolytic pills. We classified 18,525 diagnoses into five modules: non-communicable diseases (NCD), infectious disease, trauma, mental health issues, and maternal and child health (MCH) and analyzed the relations with sleep disturbance. Sleep disturbance was included in the mental health issues module and if the patient received only prescription without appropriate diagnosis, the diagnosis was classified as NCD.

Univariate and multivariate analysis revealed several risk factors related to sleep disturbance. Odds ratio (OR) of sleep disturbance was highest if the patient has mental health module (OR 83.60) followed by NCD module. If the patient has two or more diagnoses of NCD, the OR was higher (OR 2.29) than the patients with single (OR 1.83) or no description (control) of NCD. Female (OR 1.70) and age above 60 (OR 7.22) had higher risk of sleep disturbance. Patients who was diagnosed anxiety, stress distress, panic disorder, depressive status including bipolar disorder, schizophrenia and other psychiatric disease had very strong association with sleep disturbance. The place of evacuation did not significantly correlate with sleep disturbance.

Sleep disturbance is known to exacerbate NCD such as hypertension or cardiovascular diseases. The medical and non-medical support for sleep disturbance is an essential strategy after disaster.